A Novel and Personalized Rehabilitation Program for Obese Kidney Transplant Recipients

• DOI: 10.1016/j.transproceed.2014.05.085
• Publication Date: 2014-12-09T15:01:24Z
• Authors: I. Tzvetanov; P. West-Thielke; G. D'Amico; M. Johnsen; A. Ladik; G. Hachaj; M. Grazman; R.U. Heller; B. Fernhall; M.L. Daviglus; R.J. Solaro; J. Oberholzer; L. Gallon; E. Benedetti
• Keywords: Male; 2. Zero hunger; Middle Aged; Kidney Transplantation; Transplant Recipients; Body Mass Index; Exercise Therapy; 3. Good health; 03 medical and health sciences; 0302 clinical medicine; Quality of Life; Humans; Kidney Failure, Chronic; Female; Obesity; Prospective Studies; Exercise; Glomerular Filtration Rate

Physical rehabilitation programs for kidney transplant recipients are not routinely personalized to patients' physical and emotional health, which could result in a potentially limited health impact, shorter-term participation, and an overall low success rate.We conducted an internal review board-approved randomized prospective study involving a 12-month supervised multidisciplinary rehabilitation program (GH method) initiated after kidney transplantation in obese recipients (body mass index >30). The new method incorporates 3 major components: physical exercise, behavioral interventions, and nutritional guidance. We compared 9 patients who underwent supervised rehabilitation with 8 patients who underwent standard care. Patients were followed up after the start of the intervention, and multiple assessments were performed.The adherence to training and follow-up was 100% in the intervention group, compared with 25% at 12 months in the control group. There was a trend for a higher glomerular filtration rate in the intervention group compared with the control group (55.5 ± 18.6 mL/min/1.73 m(2) vs 38.8 ± 18.9 mL/min/1.73 m(2), P = .06). The quality of life (SF-36) mean score improved more in the intervention group compared with the control group (583 ± 13 vs 436 ± 22, P = .008). There was a significantly higher employment rate in the intervention group, 77.7% at 12 months compared with 12.5% in the control group (P = .02).Our preliminary results suggest that this comprehensive approach to physical rehabilitation can improve adherence, kidney function, quality of life, and employment rate for obese patients after kidney transplantation.